Key community eye health messages

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Accurate biometry is essential for good sight outcomes after cataract operations

• Measure both eyes and cross-check readings to identify errors before selecting the intraocular lens (IOL) power

• Use optical biometry wherever possible for greater precision; if ultrasound is used, ensure the probe is properly aligned and corneal compression is avoided

• Confirm that the IOL power calculation formula (for example, SRK/T, Holladay 1, or Barrett Universal II) is appropriate for the eye’s axial length

• Regularly calibrate and maintain the biometer to prevent drift and inaccurate measurements

• Recheck calculations or repeat measurements when results differ greatly between eyes or seem inconsistent with refraction

Choosing and maintaining good-quality intraocular lenses (IOLs) matters

• Always perform accurate axial length and keratometry measurements to calculate IOL power precisely

• Use a biometry formula that matches your patient population and available technology (e.g. SRK/T, Barrett Universal II)

• Inspect IOL packaging and labelling carefully before use to confirm power, sterility, and expiry date

• Record the IOL model and power in the patient’s record for postoperative audits and quality monitoring

Monitoring refractive outcomes helps improve cataract services

• Record the unaided and best-corrected sight of each patient at follow-up to assess surgical outcomes

• Compare the achieved postoperative refraction with the target refraction to identify sources of error

• Keep a register of refractive outcomes by surgeon or service site to monitor trends and guide quality improvement

• Review outcome data regularly and discuss findings during team meetings to plan corrective actions

• Use simple tools or software to calculate the mean prediction error and maintain records for audits

Training and teamwork ensure safe and consistent biometry and IOL practices

• Provide regular hands-on training for staff performing axial length and keratometry measurements

• Develop and follow standard operating procedures (SOPs) for biometry, IOL storage, and recording outcomes

• Encourage communication between the operating team, optometrists, nurses, and counsellors to avoid avoidable errors

• Assign clear roles and checklists for each stage of cataract service delivery to maintain efficiency and accountability

• Review cases with unexpected refractive outcomes as a team to promote shared learning and improvement